IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v133y2015icp36-44.html
   My bibliography  Save this article

Challenges to successful implementation of HIV and AIDS-related health policies in Cartagena, Colombia

Author

Listed:
  • Djellouli, Nehla
  • Quevedo-Gómez, María Cristina

Abstract

The Caribbean region presents the highest prevalence of HIV/AIDS worldwide after sub-Saharan Africa; leading to serious social, economic and health consequences at the local scale but also at the regional and global levels. In Colombia, a national plan to tackle the epidemic was formulated with little evidence that its implementation in the local context is effective. This study focused on Cartagena – one of Colombia's largest cities and an international touristic hub – that presents one of the highest HIV prevalences in the country, to investigate whether the national plan accounts for local specificities and what are the barriers to local implementation. Based on the Contextual Interaction Theory (CIT), this qualitative research relied upon 27 interviews and 13 life stories of local inhabitants and stakeholders, collected in a first fieldwork in 2006–2007. A follow-up data collection took place in 2013 with 10 participants: key policymakers and implementers, NGO representatives and local inhabitants. Barriers identified by the participants included: local population's understandings and beliefs on condom use; stigma and discrimination; lack of collaboration from the Church, the education sector and local politicians; corruption; high staff turnover; frequent changes in leadership; lack of economic and human resources; and barriers to health care access. The findings suggest that global influences also have an impact on the CIT framework (e.g. international organisations as a major financier in HIV prevention). The participants put forward several feasible solutions to implementation barriers. We discuss how several of the proposed solutions have been applied in other Latin American and Caribbean countries and yielded positive results. However, further research is needed to find possible ways of overcoming certain barriers identified by this study such as corruption, the lack of collaboration of the Church and barriers to health care access.

Suggested Citation

  • Djellouli, Nehla & Quevedo-Gómez, María Cristina, 2015. "Challenges to successful implementation of HIV and AIDS-related health policies in Cartagena, Colombia," Social Science & Medicine, Elsevier, vol. 133(C), pages 36-44.
    • Handle: RePEc:eee:socmed:v:133:y:2015:i:c:p:36-44
    DOI: 10.1016/j.socscimed.2015.03.048
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953615002014
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2015.03.048?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Pérez-Valbuena, Gerson Javier & Salazar-Mejía, Irene, 2008. "La pobreza en Cartagena : un análisis por barrios," Chapters, in: Meisel-Roca, Adolfo (ed.), La economía y el capital humano de Cartagena de Indias, chapter 1, pages 9-49, Banco de la Republica de Colombia.
    2. Moreno, Antonio & Alvarez-Rosete. Arturo & Nunez, Ricardo Luque & del Carmen Moreno Chavez, Teresa & Rodriguez-Garcia, Rosalia & Montenegro, Fernando & Moreno, Luis Angel & Suarez Lissi, Alejandra & C, 2012. "Evidence-based implementation efficiency analysis of the HIV/AIDS national response in Colombia," Policy Research Working Paper Series 6182, The World Bank.
    3. McDonald, Scott & Roberts, Jennifer, 2006. "AIDS and economic growth: A human capital approach," Journal of Development Economics, Elsevier, vol. 80(1), pages 228-250, June.
    4. Abadia, Cesar Ernesto & Oviedo, Diana G., 2009. "Bureaucratic Itineraries in Colombia. A theoretical and methodological tool to assess managed-care health care systems," Social Science & Medicine, Elsevier, vol. 68(6), pages 1153-1160, March.
    5. Murray, Laura R. & Garcia, Jonathan & Muñoz-Laboy, Miguel & Parker, Richard G., 2011. "Strange bedfellows: The Catholic Church and Brazilian National AIDS Program in the response to HIV/AIDS in Brazil," Social Science & Medicine, Elsevier, vol. 72(6), pages 945-952, March.
    6. Ainsworth, Martha & Beyrer, Chris & Soucat, Agnes, 2003. "AIDS and public policy: the lessons and challenges of `success' in Thailand," Health Policy, Elsevier, vol. 64(1), pages 13-37, April.
    7. Homedes, Nuria & Ugalde, Antonio, 2005. "Why neoliberal health reforms have failed in Latin America," Health Policy, Elsevier, vol. 71(1), pages 83-96, January.
    8. Abadía-Barrero, César Ernesto & Castro, Arachu, 2006. "Experiences of stigma and access to HAART in children and adolescents living with HIV/AIDS in Brazil," Social Science & Medicine, Elsevier, vol. 62(5), pages 1219-1228, March.
    9. Castro, A. & Farmer, P., 2005. "Understanding and addressing AIDS-related stigma: From anthropological theory to clinical practice in Haiti," American Journal of Public Health, American Public Health Association, vol. 95(1), pages 53-59.
    10. Berkman, A. & Garcia, J. & Muñoz-Laboy, M. & Paiva, V. & Parker, R., 2005. "A critical analysis of the Brazilian response to HIV/AIDS: Lessons learned for controlling and mitigating the epidemic in developing countries," American Journal of Public Health, American Public Health Association, vol. 95(7), pages 1162-1172.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Garcia-Subirats, Irene & Vargas, Ingrid & Mogollón-Pérez, Amparo Susana & De Paepe, Pierre & da Silva, Maria Rejane Ferreira & Unger, Jean Pierre & Vázquez, María Luisa, 2014. "Barriers in access to healthcare in countries with different health systems. A cross-sectional study in municipalities of central Colombia and north-eastern Brazil," Social Science & Medicine, Elsevier, vol. 106(C), pages 204-213.
    2. Padilla, Mark & Castellanos, Daniel & Guilamo-Ramos, Vincent & Reyes, Armando Matiz & Sánchez Marte, Leonardo E. & Soriano, Martha Arredondo, 2008. "Stigma, social inequality, and HIV risk disclosure among Dominican male sex workers," Social Science & Medicine, Elsevier, vol. 67(3), pages 380-388, August.
    3. Genberg, Becky L. & Hlavka, Zdenek & Konda, Kelika A. & Maman, Suzanne & Chariyalertsak, Suwat & Chingono, Alfred & Mbwambo, Jessie & Modiba, Precious & Van Rooyen, Heidi & Celentano, David D., 2009. "A comparison of HIV/AIDS-related stigma in four countries: Negative attitudes and perceived acts of discrimination towards people living with HIV/AIDS," Social Science & Medicine, Elsevier, vol. 68(12), pages 2279-2287, June.
    4. Gausset, Quentin & Mogensen, Hanne Overgaard & Yameogo, Wambi Maurice Evariste & Berthé, Abdramane & Konaté, Blahima, 2012. "The ambivalence of stigma and the double-edged sword of HIV/AIDS intervention in Burkina Faso," Social Science & Medicine, Elsevier, vol. 74(7), pages 1037-1044.
    5. Okada, Keisuke, 2012. "The effects of female HIV/AIDS status on fertility and child health in Cambodia," Journal of Asian Economics, Elsevier, vol. 23(5), pages 560-570.
    6. LaRusso, Maria & Gallego-Pérez, Daniel F. & Abadía-Barrero, César E., 2023. "Untimely care: How the modern logics of coverage and medicine compromise children's health and development," Social Science & Medicine, Elsevier, vol. 319(C).
    7. Arturo Vargas Bustamante & Claudio A. Méndez, 2016. "Regulating self-selection into private health insurance in Chile and the United States," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(3), pages 219-234, July.
    8. Leonardo Bonilla–Mejía & Luis Armando Galvis–Aponte, 2017. "Centro de Estudios Económicos Regionales (CEER): veinte años de investigación sobre economía regional," Documentos de trabajo sobre Economía Regional y Urbana 254, Banco de la Republica de Colombia.
    9. Fabrice Murtin & Federica Marzo, 2007. "HIV/AIDS and Poverty in South Africa: a Bayesian Estimation," Cahiers de recherche 07-08, Departement d'économique de l'École de gestion à l'Université de Sherbrooke.
    10. Marcela Arrivillaga, 2021. "Assesing Health Services in Colombia: Development of a Conceptual Framework and Measurement tools based on primary data," SAGE Open, , vol. 11(2), pages 21582440211, May.
    11. David Canning, 2006. "The Economics of HIV/AIDS in Low-Income Countries: The Case for Prevention," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 121-142, Summer.
    12. Debajyoti Biswas & Sanjukta Chatterjee & Parvin Sultana, 2021. "Stigma and fear during COVID-19: essentializing religion in an Indian context," Palgrave Communications, Palgrave Macmillan, vol. 8(1), pages 1-10, December.
    13. Aarón Espinosa Espinosa & Jhonnatan Ballestas Aviléz & Astrid Utria Payares, 2018. "Segregación residencial de afrodescendientes en Cartagena, Colombia," Revista Economía y Región, Universidad Tecnológica de Bolívar, vol. 12(1), pages 95-132, June.
    14. Archibong, Belinda & Annan, Francis & Ekhator-Mobayode, Uche, 2023. "The epidemic effect: Epidemics, institutions and human capital development," Journal of Economic Behavior & Organization, Elsevier, vol. 211(C), pages 549-566.
    15. Bhalotra, Sonia & Fernandez, Manuel, 2021. "The Right to Health and the Health Effects of Denials," The Warwick Economics Research Paper Series (TWERPS) 1376, University of Warwick, Department of Economics.
    16. Bonet-Morón, Jaime Alfredo, 2008. "Las finanzas públicas de Cartagena, 2000-2007," Chapters, in: Meisel-Roca, Adolfo (ed.), La economía y el capital humano de Cartagena de Indias, chapter 5, pages 175-202, Banco de la Republica de Colombia.
    17. Karina Acosta Ordonez, 2013. "Cartagena: Entre el progreso industrial y el rezago social," Revista Economía y Región, Universidad Tecnológica de Bolívar, vol. 7(1), pages 5-67, June.
    18. Théophile Azomahou & Bity Diene & Mbaye Diene & Luc Soete, 2015. "Optimal health investment and preference structure," Economic Theory, Springer;Society for the Advancement of Economic Theory (SAET), vol. 60(3), pages 521-565, November.
    19. Boucekkine, Raouf & Laffargue, Jean-Pierre, 2010. "On the distributional consequences of epidemics," Journal of Economic Dynamics and Control, Elsevier, vol. 34(2), pages 231-245, February.
    20. Rui Huang & Lilyan E. Fulginiti & E. Wesley F. Peterson, 2010. "Health and growth: causality through education," China Agricultural Economic Review, Emerald Group Publishing Limited, vol. 2(3), pages 321-344, September.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:133:y:2015:i:c:p:36-44. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.